Provider Demographics
NPI:1972257582
Name:SINGH, KEVIN DANIEL (PHARMD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:DANIEL
Last Name:SINGH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CRYSTALAIRE
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-8717
Mailing Address - Country:US
Mailing Address - Phone:951-565-6799
Mailing Address - Fax:
Practice Address - Street 1:25 CRYSTALAIRE
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-8717
Practice Address - Country:US
Practice Address - Phone:951-565-6799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84730183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist